Samantha Stevens is one 4-year-old who knows what she likes. The list includes Miley Cyrus, puzzles and face time with her little sister, Alana.
The list also includes food: eating, snacking and nibbling.
"I want a cheese ham sandwich," Samantha told her mom. "I want cookie ... I want cookie."
"Eventually, I cave in," mom Lori Cohen said.
But it's not just a cookie Samantha wants. She also wants French toast ... noodle soup ...
"She's a carbohydrate addict," Cohen said. "Just anything bread, anything pasta, anything sweet. ... Chocolate, any kind of cake, ice cream, bread and then meats and cheeses. She does love pasta."
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At 54 pounds, Samantha is the biggest girl in her pre-kindergarten class, Cohen said.
"She eats very slowly and deliberately and finishes everything on her plate," Cohen said. "At a birthday party she is usually the last one off the table from eating pizza or birthday cake, and she always asks for seconds."
By the standard medical definition, Samantha is actually counted as obese.
"We don't understand what a normal child looks like anymore," said Dr. Joanna Dolgoff, a Long Island, N.Y., pediatrician who specializes in weight management for kids. "Overweight has become the norm."
A parent might not recognize that a child is obese, Dolgoff said, because the child may look like all of the other kids in the neighborhood, or even slightly thinner.
"In the '70s, our kids were much thinner," Dolgoff said.
The not-so-secret recipe for childhood obesity is by now familiar: fast-food plus processed food, add in some preservatives, some sugar; and mix with video games, television, computers and our dependency on cars. All that cooks up to an epidemic, with one in three kids across the country now overweight or obese.
Just outside Nashville, Tenn., second-grader Nicholas Reeves is also battling the bulge. At 8 years old, he already weighs 117 pounds.
"He's just hungry all the time," mom,Angel Reeves said. "He can finish eating a meal and then five minutes later he's coming in the kitchen saying, 'I'm hungry again, I'm hungry again.'"
Reeves said Nick is a very active child who loves to play basketball. But his weight has already impaired his health. Nick had to have his tonsils removed because the thickness of his neck was causing sleep apnea.
"He actually weighs more than his 13-year-old brother, so he is teased by him," Reeves said.
Beyond the emotional toll of taunting and teasing, the stakes for obese children can be as high as for obese grownups. Dolgoff ticked off some of the more serious health risks.
"High blood pressure, high cholesterol, type 2 diabetes, heart attack, stroke," she said. "Being overweight during childhood decreases life span. You just want to get your overweight child healthy as soon as possible so you can maximize their life span."
Both Nicholas Reeves and Samantha Stevens embarked on an effort that their families and doctors hoped would change their habits, and therefore their lives. The children enlisted in two different programs designed for obese kids.
"I'm just hoping that like a boat, we can change her course," Cohen said of daughter Samantha.